Identification Number:
HI 00803 TN 3
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Medicare Entitlement for Individuals Exposed to Environmental Health Hazards (EHH)
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part HI – Health Insurance
Chapter 008 – Requirement for Entitlement and Termination
Subchapter 03 – Medicare Entitlement for Individuals Exposed to Environmental Health Hazards (EHH)
Transmittal No. 3, 03/18/2021

Audience

PSC: BA, CA, CS, DS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, CR, CTE, EIE, ERE, FCR, FDE, PETL, RECONE, RECONR;
OCO-ODO: BET, BTE, CCE, CR, CST, CTE, CTE TE, DEC, PAS, PETE, PETL;
FO/TSC: CS, CS TII, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

CMS

Effective Date

Upon Receipt

Background

The updates to this section include removal of an obsolete/broken form link and subsequent updates to Section B as a result of no longer using the form,

Summary of Changes

HI 00803.020 Protective Filing and Leads for EHH Medicare

 

HI 00803.020 Protective Filing and Leads for EHH Medicare

A. Protective filing for EHH Medicare

The earliest possible protective filing date for EHH Medicare is when the law became effective on March 23, 2010. Do not apply protective filing dates established prior to March 23, 2010 to EHH Medicare claims. Other than this limitation, normal protective filing rules apply. For additional information on protective filing, refer to GN 00204.010.

B. Lead for EHH Medicare

1. Establishing a lead for EHH Medicare

If an individual contacts you to file for- Medicare coverage based on exposure to an Environmental Health Hazard (HI 00803.001) take the following actions to establish a lead for EHH Medicare:

  • tell the individual that we need to obtain information from them to assist us in taking claim;

  • Establish a lead using the enhanced Leads and Appointment System (eLAS)

  • enter office Code 872 (Kalispell, Montana);

  • show the application type as HI/SMI; and

  • enter the remark, "Environmental Health Hazard Case-Contact FO 872"

  • tell the individual the SSA Kalispell, Montana office (FO 872) will contact them shortly.

2. Close out procedures for Libby Provision Medicare Leads

If FO 872 is not able to contact the individual to take the EHH Medicare claim or, if when contacted, the individual is no longer interested in pursuing the Medicare claim, FO 872 must take the following actions to close out the EHH Medicare Leads form. For more information on the EHH Medicare Leads see HI 00803.001A.

  1. a. 

    Establish Access the enhaced Leads and Appointment System (eLAS). and verify the following information:

    • the application type shows as HI/SMI;

    • Office Code 872 (Kalispell, Montana); and

    • enter the remark shows, “Environmental Health Hazard Case - Contact FO 872 if re-contacted by applicant”.

  2. b. 

    Send a close out notice via:

    • if the date the lead is established in (eLAS) is in the same month as the date of protective filing; or

    • DPS if the date of establishment of the lead in the (eLAS) is after the month of the protective filing date. date.

C. References


HI 00803 TN 3 - Medicare Entitlement for Individuals Exposed to Environmental Health Hazards (EHH) - 3/18/2021